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- Title
Late Relapses After High-dose Chemotherapy and Autologous Stem Cell Transplantation in Patients With Diffuse Large B-cell Lymphoma in the Rituximab Era.
- Authors
Hunter, Bradley D.; Herr, Megan; Meacham, Philip J.; Barlaskar, Ferdous; Evans, Andrew G.; Burack, W. Richard; Liesveld, Jane L.; Becker, Michael W.; Milner, Laurie A.; Constine, Louis S.; Dhakal, Sughosh; Barr, Paul M.; Friedberg, Jonathan W.; Casulo, Carla
- Abstract
<bold>Background: </bold>The standard of care for diffuse large B-cell lymphoma (DLBCL) relapsing after front-line therapy is high-dose chemotherapy and autologous stem cell transplantation (ASCT). Evidence has suggested that early relapses (ie, within 1 year) after this approach portends exceptionally poor outcomes. However, data examining relapses > 1 year after ASCT for patients with refractory or relapsed DLBCL are limited, in particular, in the rituximab era. We sought to examine the effect of early (≤ 1 year) and late (> 1 year) relapse after ASCT in a single-institution cohort of patients with relapsed and refractory DLBCL treated with chemoimmunotherapy.<bold>Materials and Methods: </bold>A retrospective analysis was performed on the data from 85 consecutive patients who had undergone ASCT for biopsy-confirmed relapsed or refractory DLBCL from 2001 to 2010 at the University of Rochester Medical Center. All patients had received rituximab as a part of treatment. Of the 85 patients, 35 developed relapse after ASCT. These 35 patients were divided into 2 groups according to the timing of the relapse (≤ 1 year and > 1 year after ASCT).<bold>Results: </bold>The median follow-up period was 6.4 years. For all patients, the overall survival (OS) from post-ASCT relapse was 5.2 years. For the 27 patients developing relapse at ≤ 1 year after ASCT, the median OS was 0.6 year and progression-free survival was 0.4 year. For the 8 patients developing relapse at > 1 year after ASCT, the median OS was 5.9 years and progression-free survival was 2.9 years.<bold>Conclusion: </bold>Patients with relapsed or refractory DLBCL experiencing relapse > 1 year after ASCT had good outcomes. Despite the relative rarity in incidence, a significant risk of relapse of DLBCL after ASCT remains, suggesting the need for continued monitoring because of the possibility of later progression.
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2017, Vol 17, Issue 3, p145
- ISSN
2152-2650
- Publication type
journal article
- DOI
10.1016/j.clml.2016.11.001